Among the processes that influence the healthcare revenue cycle, pre-authorization stands out—and not in a good way! Most provider organizations are still managing pre-authorizations the old fashioned way: manually, with paper, pen, fax, and phone. These ad hoc methods of securing and confirming payer approval for non-emergency medical services are error-prone and inefficient, and often lead to denied or rejected claims or, worse, delays in service. Few organizations file claims manually any longer. Why, then, are we still completing, filing, and managing pre-authorization requests as if it's 1980? Technology advancements finally make it possible for providers to standardize and centralize…
Pre-service authorization is a tedious, time consuming, and costly process for most providers. And issues related to pre-authorization are a major source of claims denials.
Those are just some of the pre-authorization pain points reported by HealthLeaders Media in a new survey of 158 senior clinical, operations, marketing, and financial leaders from non-profit and for-profit providers nationwide.
The study, commissioned by RelayHealth Financial, ranks pre-service authorization pain points and helps identify areas where improved processes and technology could help streamline payment and reduce denials.
Prior authorizations don't have to be a costly, tedious, or manual process. What if we could automate and streamline authorizations, so clinicians could request and receive an authorization in minutes if not seconds, without touching paper, phone, or a fax machine--and without ever leaving their preferred care management platform? We can now stop asking "what if?" McKesson and ZeOmega are bringing automated authorization with medical review to the forefront, because now ZeOmega's Jiva population health platform interoperates with McKesson’s InterQual Connect. See how it works. Discover how this partnership delivers on the promise of exception-based UM. And learn why it…
RelayClearance Authorization now includes more than 635,000 payer-specific authorization policy screening rules from 549 commercial, managed care, and government health plans. The solution helps streamline prior authorization processes in real time. Read the article
Today RelayHealth Financial announced that its RelayClearance Authorization solution now includes more than 635,000 payer-specific authorization policy screening rules from 549 commercial, managed care, and government health plans. That means providers using RelayClearance Authorization have access to updated screening rules from payers covering more than 90% of covered lives. Read the news release
Pre-authorization is time consuming, costly, can delay care, and is a major source of claims denials. Those are just a few of the pre-authorization pain points reported in a survey of C-suite provider executives nationwide. This white paper reports and ranks pre-authorization problems, delves into the issues, and provides a path forward to improve pre-authorization to create more automated and streamlined system. Read now or download and read later
Pre-authorizations can be costly, time-consuming, frustrating for all involved, and can account for a large percentage of denials. It's no surprise that health care networks are increasingly turning to technology to automate the process. Fixing Healthcare’s Broken Pre-Authorization Screening & Verification Model lays out how automation and other necessary components can transform the pre-auth process to be faster, more efficient, and more economical. Read now or download and read later
Organizations have two choices when it comes to pre-authorizations: continue to rely on costly manual processes or implement technology that automate pre-authorization screening, verification, and monitoring. There's a lot that can be done to overcome the existing model. Read the article
This new video from RelayHealth Financial takes a humorous jab at the constant ID requests that patients have to provide along every step of their healthcare journey. Watch the video
RelayHealth Financial has created an expansive pre-authorization network of more than 200 payers to help speed authorizations, patient care, and payments for its clients. The health plans using RelayHealth represent nearly 80% of covered lives in the U.S. Read the article